March 31, 2017

Stretta Therapy

Stretta therapy is a non-surgical endoscopic outpatient procedure that delivers radiofrequency (RF) to the Lower Esophageal Sphincter (LES) to treat gastroesophageal reflux disease (GERD). Although its exact mechanism for correcting a defective LES is not fully understood, studies have concluded that Stretta reduced transient LES relaxations (opening of the LES without swallowing) and decreased tissue compliance (made the LES stiffer).(1)

Stretta therapy.

Stretta was initially approved by the FDA in 2000 for treating patients who have GERD with its second iteration approved in 2011. The procedure is well studied and demonstrates improvement in reflux symptoms and quality of life scores.(2) Additionally, while esophageal acid exposure decreased from a preprocedure De-Meester score of 44.4 to 28.5 (2), it should be noted that the normal De-Meester score is 14.7 or less. The most common side effect is mild to moderate pain after the procedure.

 

Candidates for Stretta include individuals who have failed medical management and choose to manage their GERD without surgery. Stretta is not indicated for patients with hiatal hernias greater than 2 cm.

A comparison of Stretta therapy with other procedures can be found on our pros and cons page.

  1. Auyang ED, Carter P, Rauth T, et al. SAGES clinical spotlight review; endoluminal treatments for gastroesophageal reflux disease (GERD). Surg Endosc 201; 272658-72.
  2. Perry KA, Banerjee A, Melvin WS. Radiofrequency energy delivery to the lower esophageal sphincter reduces esophageal acid exposure and improves GERD symptoms: a systematic review and meta-analysis. Surg Laparosc Endosc Percutan Tech 2012;22:283-8